Lawmakers appeal for funding of physician program

The state Legislature’s Big Island delegation is calling for “full funding” of a program designed to bring more doctors to the Big Island.

A joint informational briefing to discuss a $2.8 million appropriation to get the program started later this calendar year will be held at the State Capitol in Honolulu today. The bill also calls for the same appropriation next year.

Ten of 11 Hawaii County legislators signed a letter endorsing the program, known as the Hawaii Health Systems Corporation Primary Care Training Program at Hilo Medical Center on March 25. Sen. Malama Solomon was unavailable to sign the letter but she also backs the proposal, said a spokesman in Solomon’s Honolulu office.

Funding for the program is “critically needed to bring high quality, lower cost health care to the residents of Hawaii’s neighbor islands,” said the delegation’s letter to the state House Finance and Senate Ways and Means committees.

House Bill 417, HD2, which establishes the program, was approved by both houses of the legislature but without the funding. Now the discussion is about cost.

The delegation noted that Hawaii is currently 200 primary care physicians short of its need, with more than 30 percent of currently practicing doctors being over 60 years old. The County of Hawaii is 63 physicians short of its need, said Kaloa Robinson, marketing director for HMC.

Hawaii Island’s legislators said $2.8 million annually is the minimum amount necessary to “establish a base for the primary care training program, faculty and facilities,” and that 12 physicians in the initial program is the minimum number of physicians required for program accreditation. Any fewer than 12 would “drastically diminish the ability of this program to address Hawaii’s needs.” Proponents are seeking $2.8 million each for the next two fiscal years, for a a total of $5.6 million to support the program.

“With an anticipated national shortage of 52,000 primary care physicians by 2025, this is the only realistic and sensible approach,” the delegation said, and the investment would pay for itself by reducing unnecessary emergency room visits and hospitalizations throughout the state, and by raising the rates of child immunizations.

Indicative of the problem on the Big Island is that Hilo Medical Center’s emergency room is the second busiest in the state, behind only Queen’s Medical Center in Honolulu, Robinson said, and that the island has higher rates of residents who rely on the emergency room for primary care needs. One in 10 said they went without care due to the inability to access a primary care provider, which often leads to hospitalizations that can cost up to 10 times the cost of a primary care provider.

State Sen. Josh Green, D-Kona, an emergency room physician in West Hawaii, has been a driving force behind the program, estimated Wednesday that chances are 50-50 that the program will be fully funded.

“The community is behind it in Hilo,” he said. “It’s gotta be a priority for the state.” However, Green acknowledged that committing $5.6 million to the program over the next two years “will be a tough sell to Oahu legislators who don’t experience the same thing as we do.”

The $2.8 million appropriation would be for the first year and similar annual appropriations would be required before federal funding becomes available for the program, said Robinson.

“In our analysis, the (program) is “an excellent investment at $2.8 million per annum,” said the Big Island legislators.

The program has attracted widespread support and positive testimony from many quarters throughout the state, including Neighbor Island mayors and lawmakers, major health care organizations, businesses, individuals and island chambers of commerce.

Scheduled to testify at the informational session today will be representatives from the state departments of Health, and Labor and Industrial Relations; Dr. Chip Dixon, John A. Burns School of Medicine; Howard Ainsley, CEO of the East Hawaii Region/Hilo Medical Center; Laura Gomez, University of Hawaii at Hilo School of Pharmacy; and Stephanie Marshall, UH-Manoa School of Nursing and Dental Hygiene.

Ainsley testified before the House Ways and Means Committee in March that a 2012 Community Health Profile report identified Hawaii County as having the lowest ratio of licensed physicians per 100,000 population compared to the other counties in Hawaii, and that Hawaii County has 14 percent of the state’s population but only 10 percent of the state’s physicians.

Following the informational briefing on Friday, a legislative conference committee is scheduled April 24 for final decision-making, Robinson said.

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